Form Center

2. ADA Grievance Form

   Title II of the American with Disabilities Act (ADA) requires the City of Wheat Ridge to have a process and complaint form in place to address matters related to discrimination based on a disability. This discrimination could be lack of facility and program access, attitudinal, or policies and procedures preventing access. If you feel, based on a disability, you have been discriminated against please fill out this form. Please provide as much detail as possible.

4. Is this a facilities or website related concern?

   1. Facilities
   2. Website
6. Please describe the nature of your concern
8. For website concerns, please provide the link to the webpage
12. Contact Information
14. Name
16. Email
17. Phone Number
19. Address
Leave This Blank:


21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

* indicates a required field